Saturday, June 14, 2014

GateHouse: Prisons, America’s ‘new asylums’

Matthew T. Mangino
GateHouse News Media
June 13, 2014
A new report by the Treatment Advocacy Center, “The Treatment of Persons with Mental Illness in Prisons and Jails,” has found that the number of individuals with serious mental illness in prisons and jails now exceeds the number in state psychiatric hospitals by a factor of 10.

In 2012, there were an estimated 356,268 inmates with severe mental illnesses in U.S. prisons and jails. There were only 35,000 mentally ill individuals in state psychiatric hospitals.

The report suggests that prisons and jails have become America’s “new asylums.”

“In 44 of the 50 states and the District of Columbia, a prison or jail in that state holds more individuals with serious mental illness than the largest remaining state psychiatric hospital,” according to the report prepared by the TAC, a nonprofit organization dedicated to the timely and effective treatment of severe mental illness.

Mental health agencies are not the only entities sounding the alarm. Cook County, Illinois, Sheriff Tom Dart says that society has cast aside the mentally ill, which is the primary reason why prisons are overcrowded in his state.

According to the Chicago Defender, the Cook County Jail is currently the largest mental health facility in the U.S. with 30-35 percent of its 9,000 daily population living with a serious mental illness.

“Society doesn’t want to fund mental health [programs],” said Dart.

Bob Carolla, a spokesman for the National Alliance on Mental Illness, told the Defender that people will end up in the prison system if they don’t have access to “adequate and effective” mental health treatment.

“In [the] last few years we’ve seen massive state budget cuts in mental health services, so that makes the problem only greater, with more people being funneled into jail,” he said.

Untreated psychiatric illness often gets worse. The problems are not just inside the prison walls. Many inmates with mental health problems leave prison more unstable than when they entered. The treatment of inmates with mental illness can be very costly and is often a strain on corrections’ budgets.

Just as important, inmates who are transitioning back into the community need to have immediate and seamless mental health services. Without adequate treatment the results can be catastrophic.

Last weekend, a Brooklyn, New York, man, with a history of psychiatric commitments, was accused of stabbing two children in an elevator. Investigators indicated that he may not have connected with mental health services after being released from prison on May 23.

Brian Stettin, policy director of the TAC, told CBS News, “You can’t just drop someone with severe mental illness into the community and expect they’re going to find their way to treatment.”

Last December, President Barack Obama told an audience at the National Conference on Mental Health, “[L]ess than 40 percent of people with mental illness receive treatment … even though three-quarters of mental illnesses emerge by the age of 24, only about half of children with mental health problems receive treatment.”


It is extremely difficult to find a bed for a seriously mentally ill person who needs to be hospitalized. In 1955 there was one psychiatric bed for every 300 Americans. In 2005 there was one psychiatric bed for every 3,000 Americans.

According to the TAC’s report, “one of the driving forces behind the closure of state mental hospitals and subsequent transinstitutionalization of mentally ill individuals from hospitals to prisons and jails has been a belief that it saves money.”

Those savings may be illusory.

The TAC makes a cogent argument for unbiased cost assessments that identify the comprehensive expense of incarcerating mentally ill individuals and provide public officials with a more accurate basis for making mental illness treatment policy.

Matthew T. Mangino is of counsel with Luxenberg, Garbett, Kelly & George P.C. His book “The Executioner’s Toll, 2010” was recently released by McFarland Publishing. You can reach him at and follow him on Twitter at @MatthewTMangino.
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